In the presence of a small aortic annulus, aortic valve replacement can be challenging. Several annular enlarging techniques have been described to allow placement of an adequately sized prosthesis. In patients who have undergone prior cardiac surgery, particularly for congenital heart defects, standard techniques may require modification. This case describes the challenges of enlarging the aortic annulus after previous arterial switch operation for transposition of the great arteries. Specifically, the Konno aortoventriculoplasty following arterial switch operation requires pulmonary valve disruption and right ventricular outflow tract reconstruction.